The clinical value of enzyme-multiplied immunoassay technique monitoring the plasma concentrations of cyclosporine A after renal transplantation

The feasibility and the clinical value of the enzyme-multiplied immunoassay technique(EMIT)monitoring of blood concentrations of cyclosporine A(CsA)in patients treated with CsA were investigated after kidney transplantation.The validation method was performed to the EMIT determination of CsA blood concentration,the CsA whole blood trough concentrations(C0)of patients in different time periods after renal transplantation were monitored,and combined with the clinical complications,the statistical results were analyzed and compared.EMIT was precise,accurate and stable,also with a high quality control.The mean postoperative blood concentration of CsA was as follows:<1 month,(281.4±57.9)ng/mL;2-3 months,(264.5±41.2)ng/mL;4-5 months,(236.4±38.9)ng/mL;6-12 months,(206.5±32.6)ng/mL;>12 months,(185.6±28.1)ng/mL.The toxic reaction rate of CsA blood concentration within the recommended therapeutic concentration was 14.1%,significantly lower than that of the none-recommended dose group(37.2%)(P<0.05);the transplantation rejection rate was 4.4%,significantly lower than that of the none-recommended dose group(22.5%)(P<0.05).Using EMIT to monitor the blood concentration of CsA as the routine laboratory method is feasible,and is able to reduce the CsA toxicity and rejection significantly,leading to achieving the desired therapeutic effect.

Multiple Respiratory Gas Monitoring Causes Changes of Inspired oxygen Concentration in Closed Anesthesia System

Effect of multiple respiratory gas monitoring (MRGM ) on inspiredconcentration of oxygen in circult system during closed anesthesia was studied in 5l adult patients scheduled for abdominal surgery. Required flow rate of fresh oxygen (OFR), inspired oxygen concentration (FiO2 ) and oxygen saturation of pulse oximeter (SpO2) were measured continu0usly. Patients were equally divided into three groups at randorn, group C (no MRGN used ), group M, (using MRGM with its tail gas returned to circuit system), group M2 (using MRGM without tail gas returned ). The results revealed that during 180 min of closed anesthesia, OFR required in group C and M, were about 200-230 ml/min, and in group M, it was ab0ut 400 ml/min. In group C FiO2 decreased by about 10 % after 60 min of closed anesthesia (P<0. 01, 60 min vs 0 min ) and then stayed stable at this level. In group M,, FiO2 decreased by 16% at 60 min and 34 % at 180 min and the decrease was significantly greater than that in gr0up C (P<0. 01). In group Me, FiO2 remained c0nstant during closed anesthesia, which was much high(Jr than those in group C and M,. The tail gas of Capnomac Ultima MRGM contained less oxygen than its sample gas drawn fr0m circuit system simuItaneously.

Gas concentration monitoring system for small and medium-sized coal mines based on gas-sensing detection and single-chip control

这份报纸针对气体在小、中型的煤矿引起的灾难的实际条件。为煤矿监视系统的新煤气的集中根据煤气察觉到的察觉和单个薄片的控制被开发。因为它为易燃、爆炸的气体有好敏感特征，监视系统把锡氧化物用作 N 类型半导体气体传感器的主要材料(例如甲烷，碳一氧化物) 。QM-N5-semiconductor 煤气的传感器被采用在不同煤气的集中下面检测抵抗的产量价值。故意地，系统拿数字薄片抵抗作为处理硬件结构分析并且判定输入的电路的核心珍视的 AT89C51，然后为超出煤气的集中的限制完成控制和警报。监视系统的煤气的集中有许多优点包括在结构，快反应时间，稳定的表演和低费用简单。因此，监视煤气的集中并且在小、中型的煤矿提供早警告能广泛地被用来。

Monitoring and Evaluation on Indoor Radon Concentration in a District of Xi'an

[Objective]The research aimed to monitor and evaluate indoor radon concentration in one district of Xi'an City. [Method] In order to master the effective dose per year caused by natural radiation to local residents,the investigation about the level of indoor radon in one district of Xi'an was developed. Based on the proper monitoring scheme,some typical living rooms were sampled. Through the measurement result,the effects of different factors on radon concentration were obtained. Finally,the radon concentration was transferred into the effective dose per year of local residents. [Result]Indoor radon concentration in the district was during 49. 680-128. 856 Bq /m3,and average concentration in each building was within 100 Bq /m3,which belonged to normal range. When sunny day became rainy day,radon concentration firstly had a rise trend. If continuous rainy weather appeared,indoor radon concentration gradually declined. When other conditions were same,indoor radon concentration under window closing was significantly higher than that under window opening. Indoor radon concentration had a decline trend from 13: 00 to 20: 00 and a rise trend from 01: 00 to 06: 00. [Conclusion]The district belonged to radon safety house. To protect residents' health to the maximum extent,according to transfer change rule of the radon,window should be opened to ventilate in the morning when radon concentration was higher.

A non-invasive method for gastrointestinal parameter monitoring

AIM: To propose a new, non-invasive method for monitoring 24-h pressure, temperature and pH value in gastrointestinal tract.METHODS: The authors developed a miniature, multifunctional gastrointestinal monitoring system, which comprises a set of indigestible biotelemetry capsules and a data recorder.The capsule, after ingested by patients, could measure pressure, temperature and pH value in the gastrointestinal tract and transmit the data to the data recorder outside the body through a 434 MHz radio frequency data link. After the capsule passed out from the body, the data saved in the recorder were downloaded to a workstation via a special software for further analysis and comparison.RESULTS: Clinical experiments showed that the biotelemetry capsules could be swallowed by volunteers without any difficulties. The data recorder could receive the radio frequency signals transmitted by the biotelemetry in the body. The biotelemetry capsule could pass out from the body without difficulties. No discomfort was reported by any volunteer during the experiment. In vivo pressure and temperature data were acquired.CONCLUSION: A non-invasive method for monitoring 24-h gastrointestinal parameters was proposed and tested by the authors. The feasibility and functionality of this method are verified by laboratory tests and clinical experiments.

Design and development of a plastic scintillator based whole body β/γ contamination monitoring system

Plastic scintillation detectors based whole body β/γ contamination monitors are developed for use in radiation facilities.This microcontroller-based multi-detector system uses 13 plastic scintillator detectors,with minimized dead detection zones,monitoring the whole body,and conforming to the contamination limit prescribed by the regulatory authority.This system has the features for monitoring hands,feet,head,and faceβ/γusing contamination monitors and portal exit monitors.It can detect gamma sources at a dose rate of 10 n Gyh^(-1).The system is calibrated using b sources^(90)Sr/^(90)Y,^(204)Tl,and^(36)Cl,and the efficiency is found to be 29%,22%,and 18%,respectively.Theminimumdetectableβ/γcontaminationis0.15 Bqcm^(-2),which is significantly less than the minimum detection objectives on head,face,hands,and feet.

Trace Elements in Lake Baikal: Current Status, Forecast and Monitoring Problems

Assessment of the current status of Lake Baikal proved to be based on changes in natural (“preindustrial”) chemical content in basic abiotic and biological compartments of the Lake geosystem. This approach was used to evaluate background “base-line levels” of 6 major and about 50 minor and trace ele-ments in the Lake Baikal water body using a number of most reliable data re-ported within 1992-2012. In terms of environment geochemistry Baikal is one of the purest water reservoirs on the Earth. A simple mass balance model was proposed for assessing possible anthropogenic impact on Baikal water geo-chemistry. Estimations of change trends showed that only for Na+, SO42-, Cl- and Mo growth rate of their average concentrations in the Lake occurred to be 1%, 3%, 7% and 2% in every 10 years. Space-time monitoring schedules for all water body compartments of the Lake are proposed as well as similar moni-toring programs for tributaries, precipitations, bottom sediments, aquatic biota.

Angle Scattering Method for Soot Concentration Measurement under Ultra-Low Emissions Condition

Aiming at the problem of soot concentration measurement under ultra-low emission conditions,a forward small angle soot concentration measurement method is proposed.Taking a typical boiler emission of 0.1μm-3.0μm bimodal distribution soot as an object,the particle scatter simulation calculation under different parameters is carried out,and the influence of detection angle and particle size on the angular scatteringmeasurement of ultra-low emission soot is analyzed.The influence of detection angle and particle size on the angular scatteringmeasurement of ultra-lowemission soot is analyzed.Preferably,thewavelength of incident light is 650 nm,and the forward detection angle parameter is 15◦for the design of forward small angle soot concentration measurement system.An experimental system for measuring soot with standard concentration is built.Experiments of particle concentration measurement of 1.0μm and 3.0μm under ultra-low emission conditions are carried out.The results show that the average deviation of soot concentration measurement is less than 0.10 mg/m3 under the condition of ultra-low emission by using 15◦of forward detection,which provides an effective way for monitoring ultra-low emission soot concentration in coal-fired power plants.

Individualized Isonatremic and Hyponatremic Dialysate Improves Blood Pressure in Patients with Intradialytic Hypertension: A Prospective Cross-Over Study with 24-h Ambulatory Blood Pressure Monitoring

Background. Intradialytic hypertension, a paradoxical rise in systolic blood pressure from pre- to postdialysis, is a poorly understood and difficult-to-treat phenomenon. We examined the effects of individually adjusted isonatremic and hyponatremic dialysate on intradialytic and interdialytic blood pressure in patients with intradialytic hypertension. Methods. We enrolled 11 patients with intradialytic hypertension in a prospective randomized cross-over study, with 4 treatment periods of different dialysate sodium concentrations. Period 1 (run-in) and 3 (wash-out) were standardized at 140 mEq/L;period 2 and 4 with iso- or hyponatremic sodium dialysate. Blood pressure was recorded each dialysis session, and 24-hour ambulatory blood pressure monitoring was performed at the end of each treatment period. Results. Isonatremic and hyponatremic dialysate were associated with significantly lower pre- and post-dialysis blood pressure as compared to baseline 140 mEq/L dialysate (predialysis 148.3 ± 24.7/67.7 ± 12.0 and 144.4 ± 16.5/68.8 ± 13.3 vs. 158.0 ± 18.3/75.6 ± 11.4 mmHg, resp p = 0.04 and 0.007 for systolic and p = 0.004 and 0.04 for diastolic blood pressure;postdialysis 154.2 ± 25.5/76.6 ± 14.1 and 142.5 ± 20.7/73.0 ± 12.9 vs. 159.1 ± 21.6/80.3 ± 12.1 mmHg, resp NS and p = 0.01 for systolic and NS and p = 0.04 for diastolic blood pressure). Postdialysis and 24 h systolic blood pressure tended to be lower with hyponatremic compared to isonatremic dialysate. Conclusion. Individually tailoring dialysate sodium concentration, based on the sodium set-point of each patient, resulted in a lower pre- and post-dialysis blood pressure in patients with intradialytic hypertension. 24 h blood pressure values tended to be lower as well with hyponatremic dialysate.

Gastroesophageal manometry and 24-hour double pH monitoring in neonates with birth asphyxia

INTRODUCTIONBirth asphyxia may lead to disturbances of gastroenteric motility of newborn infants[1.2] . The change of gut pressure and reflux are the major manifestations of the motor disturbance [3-9] . To evaluate the effects of perinatal asphyxia on the gastroenteric motility, gastric and esophageal pressure and double pH were measured in a group of asphyxiated newborns. And. their pathophysiological and anatomical effects on gastroenteric function were discussed.

Gas concentration pre-warning system based on fuzzy structured element

In order to accurately test gas concentration and effectively pre-warning when the gas concentration over-limited on work face,used the high-performance and low prices SCM and the low-cost and high transfer efficiency bluetooth technology to forecast the gas concentration in real time.The data tested by SCM,then got the corresponding mathematical model of the data.Put forward the idea of using fuzzy structured element theory to dynamic forecast the gas concentration,analyzed the features in abnor- mal-effusing on work face and judge whether there was the possibility of abnormal gas-effusion.Simulation results show that mathematical model of this system about gas concentration is correct.This system changes coal mine monitoring system's traditional way of after-alarming into early-warning,and thus enhances its feasibility.

万古霉素在重症感染中的治疗药物监测现状及前景

万古霉素被誉为治疗革兰阳性菌感染的最后一道防线,也是推荐的一线用药。因其治疗窗窄,重症患者需监测药物浓度以指导临床安全用药。传统上基于万古霉素谷浓度的治疗药物监测已被临床广泛接受。2009年美国传染病学会(IDSA)指南建议,对于重症患者目标谷浓度为15~20 mg/L。近十余年国内外学者对于该治疗浓度的安全性及有效性评价不一。2020年更新指南提出,肾损伤风险最小、最准确且最佳的给药方法是通过曲线下面积(AUC)指导给药剂量和监测,提倡个体化目标AUC/最低抑菌浓度(MIC)比值为400~600 mg/(h·L)。由此可见目前就万古霉素临床监测指标存在争议。因此,本文就万古霉素治疗重症感染过程中进行治疗浓度监测的手段及策略进行综述,对指导临床合理用药具有重要意义,有助于临床医师制定个体化给药方案,最大程度减少或避免药物毒性。

左乙拉西坦治疗药物监测的研究进展

左乙拉西坦(LEV)是第二代广谱抗癫痫药物,具有起效快、半衰期短、疗效确切、耐受性好、药物相互作用少等优点。为提高LEV的临床效果,减少不良反应的发生,应对儿童、妊娠期妇女、老年人、肾功能不全等特殊人群予以治疗药物监测(TDM)。临床上LEV监测样本常选择血浆或血清,监测方法多选择免疫分析法或色谱分析法。LEV的有效浓度范围目前尚无统一意见,血药浓度与不良反应的相关性也不明确。影响LEV血药浓度的因素主要有年龄、妊娠及患者用药依从性等。如何解读TDM结果并根据结果调整给药剂量是今后工作的重点。

万古霉素治疗药物监测的热点与进展

治疗药物监测是维持万古霉素疗效和预防不良反应的重要手段,并有助于制定个体化的给药剂量方案。随着中国和美国指南关于治疗药物监测指标的更新,以24 h药-时曲线下面积(AUC_(24 h))引导的治疗药物监测逐渐成为热点。与谷浓度引导的治疗药物监测相比,AUC_(24 h)引导的治疗药物监测能够降低万古霉素引起的急性肾损伤的发生率。临床上可以通过贝叶斯法和线性药代动力学方法来实施AUC_(24 h)引导的治疗药物监测,这2种方法均可以实现AUC_(24 h)的预测,达到早期干预的目的。各医疗机构有必要根据机构实际情况选择合适的监测方法。

某院2022年丙戊酸钠血药浓度监测结果分析

目的分析某院丙戊酸钠(VPA)血药浓度监测结果及其影响因素,为临床合理用药提供参考。方法回顾性收集2022年1月~12月在常熟市第二人民医院行VPA血药浓度监测的241例患者资料,采用卡方检验或Fisher精确检验分析年龄、药物剂型及联合用药对VPA血药浓度的影响。结果241例患者共行438例次VPA治疗药物监测,血药浓度达标率为58.7%。监测多次的患者中,调整剂量后的监测结果达标率较调整前均有提高。单因素分析显示,剂型和联合用药是影响VPA血药浓度的相关因素(P<0.05)。结论临床使用丙戊酸钠时应注重血药浓度监测,并及时根据监测结果及临床症状调整给药剂量,以提高抗癫痫治疗效果,降低不良反应发生率。

复方磺胺甲噁唑血药峰浓度测定对治疗非人类免疫缺陷病毒感染患者耶氏肺孢子菌肺炎的临床意义

目的:探索监测复方磺胺甲噁唑(sulfamethoxazole complex, SMZco)中SMZ血药峰浓度对接受SMZco片治疗的非人类免疫缺陷病毒(immunodeficiency virus,HIV)感染患者耶氏肺孢子菌肺炎(Pneumocystis jirovecii pneumonia,PJP)疗效和安全性的指导意义。方法:采集2019年1月至2023年5月在瑞金医院住院治疗的非HIV PJP患者的临床数据,回顾性分析患者SMZ血药峰浓度与疗效和不良反应发生情况的关系。结果:共纳入47例患者,SMZ的血药峰浓度范围为87.49~334.31 mg/L,中位数(四分位间距)为168.62(79.72)mg/L,64%的患者血药峰浓度>150 mg/L。患者30 d全因死亡率为28%,治疗阳性反应率为66%。其中,SMZ血药峰浓度≤150 mg/L患者与>150 mg/L患者30 d全因死亡和治疗阳性反应率差异无统计学意义。29例(62%)患者发生不良反应。相比SMZ血药峰浓度≤150 mg/L的患者,>150 mg/L的患者血小板减少(40%比6%,P=0.025)和血红蛋白降低(37%比0,P=0.013)等不良反应发生率更高,且严重不良反应的发生率更高(43%比12%,P=0.026)。结论:SMZco片用于治疗非HIV PJP患者时,SMZ血药峰浓度≤150 mg/L的患者较>150 mg/L的患者可获得相当的疗效,且发生严重不良反应的风险更小,建议该类患者常规监测SMZ血药峰浓度。

基于基因检测和血药浓度监测技术优化肝移植术后他克莫司个体化给药方案

他克莫司是广泛应用于临床的钙调神经磷酸酶类抑制剂,被作为肝移植术后预防和治疗急性排斥反应的一线药物。然而,在临床应用中,他克莫司表现出治疗窗口窄、药动学个体差异大等特点,移植后早期低浓度的他克莫司可能会诱发排斥反应;而高浓度的他克莫司可能会导致肾毒性和/或神经毒性,因此对于他克莫司药动学的影响因素进行深入研究至关重要。本文通过检索中国知网(CNKI)、维普、万方以及PubMed数据库,综述了临床上对患者实行基因检测和血药浓度监测的必要性,得出根据基因多态性进行给药以及寻找替代药时曲线下面积的最佳采样点策略可能将有助于临床医生对他克莫司的最佳起始剂量进行预测,进而帮助调整维持方案,且有望减少不良反应的发生。